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Mutations in the epidermal growth factor receptor (EGFR) gene are commonly observed in non-small-cell lung cancer (NSCLC), particularly in adenocarcinoma histology (aNSCLC). The frequency of EGFR mutations is ethnicity-dependent, with a higher proportion in Asian populations than Caucasian populations. Yet there is a lack of data of these mutations among North African patients. The aim of this study was to report the frequency and types of EGFR mutations in a group of NSCLC Moroccan patients.

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Methods

Tumor specimens from Moroccan patients with NSCLC were collected, between November 2010 and December 2017 to determine frequency and types of EGFR mutations. Tumors were tested for EGFR by polymerase chain reaction and sequencing of exons 18, 19, 20, and 21.

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Results

A total of 334 patients were consequently enrolled: 242 (72.5%) males and 92 females (27.5%), with a mean age of 61.9 years. 56.9% had a history of smoking, and only the adenocarcinoma histology are considered .EGFR testing of 334 (100%) demonstrated wild typein 261 (78.1%) and mutated EGFR in 73 (21.9%).Mutations were mainly detected in the exon 19 (65.8%), followed by exon 21 L858 (17.8%),exon 21codon (5.5%) and exon 18 (6.8%), whereas mutations in the exon 20 were less frequent(4.1%). In patients with aNSCLC, the detection of EGFR mutation was independently associated with gender (41,3% females Vs.14,5% males; p < 0.001) and smoking status (34.8% non-smokers Vs. 12.9%, p < 0.001).

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Conclusions

Our findings confirm the genetic heterogeneity of NSCLC worldwide, reporting frequency of EGFR mutations in NSCLC Moroccan patients intermediate between Asian (50%) and Caucasian (15%) populations. The substantial lack of data from several large geographic regions of the world, notably our region, highlights a potential lack of routine mutation testing and consequent access to EGFR targeted agents, suggesting the need for further research implementations in Morocco.

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